Background

Question:

Discuss about the Analysis Of The “No Jab No Pay” Public Health Policy.

The Australian government has been in forefront of addressing issues related to public health by putting in place the relevant strategies and initiatives aimed at promoting the growth of a healthy nation. In its efforts to formulate policies the government takes into consideration the concerns raised by various stakeholders in the health sector in order to ensure that the policy meets the set objectives. However, in most cases, the implementation of these policies have not been an easy task on the side of the government as the policy implementation process is always met with certain economic, political and social factors or challenges (Wang et al., p. 67, 2017). Among the many public health policies formulated by the Australian government with a collaboration with other health agencies such as the Commonwealth as well as the state and federal governments are the immunization policy and in this case the “ No Jab No Pay” immunization policy which was implemented in January 2016. The aim of the policy was to improve the health status of children in Australia by increasing the rates and the number of immunized children among the Australian population. To achieve this policy targeted the families with children who are not immunized and therefore the governments sought to withdraw the health benefits enjoyed by these groups of people in relation to FBT-A end of year supplement, the child care benefits (CCB) and the childcare rebate (CCR) health benefits (Braunack-Mayer et al., p. 1402, 2016). This study, therefore, seeks to provide an understanding of the factors affecting the implementation of policy as well as the relationship and intersection between various aspects of the policy-making process.

This policy was proposed in 2015 when the Australian government proposed that it would end off some exemptions from the children immunization requirements for eligibility for accessing the health care benefits including the FBT- A end of year supplement, the child care benefit as well as the childcare benefit (Handy et al., p. 11, 2017). The reason for such a move by the government was because the government was concerned at the risk caused by non-vaccinated children to the public health. The policy came into place as in consolidation with the government initiative adopted in 1998 which had attached certain requirements for children to meet immunization schedules to children payments. The policy, however, had affected certain groups in society such as the Church of Christ and others who had submitted a conscientious objection to the immunization. Later after a discussion between the ministers of social services in Australia together with the Church of Christ, they agree the exemption to the church would do away with as it was no longer necessary (Wiley et al., p. 7, 2017). The government has therefore taken measures through this policy to initiate its preventive healthcare initiatives to improve the health status of the children and promote the growth of a healthy nation. The implementation of the policy, therefore, calls s for the collective efforts of all the stakeholders involved or affected by the policy. The success of the implementation process willbe determined by the relationships and intersection between the various stakeholders and aspects in the implementation process and the evaluation of the key factors overlooked in the policy-making process. The policy is therefore aimed at increasing the vaccination rates among children and adolescents as well as reducing the spread of vaccine-preventable diseases among the young population in Australia.

Social Factors

For the policy to be formulated, adopted and implemented a number of historical factors contributed to the implementation of the policy. In 1993, the Australian health sector established the first Australian Immunization Strategy that ruled out compulsory vaccination and allowed conscientious objections to be acceptable grounds for not vaccinating children. This move however led to deterioration health status of children as many children were found not to be vaccinated. In 1996, the health sector introduced a child immunization register that helped in collection of data on vaccination rates for children and in the year 1997 the health sector introduced a childhood immunization program that provided financial assistance to families to help in improvement of the vaccination rates till January 2016 when the No Jab No Pay policy was implemented.

The implementation of the policy can only be successful if the policymakers take into consideration the social factors likely to affect the implementation. Social factors, in this case, refer to the issues resulting from the interactions and links between the policymakers and the other stakeholder and especially the population that is affected by the policy (Taylor et al., p. 18, 2016). In this case, the immunization health policy main stakeholders include the government and other agencies involved in the formulation of the policy and the parents or families with children who are not immunized or have not been scheduled for immunization. There is a need for effective communication by the side of the government to the families or parents with children as they are the main target of the policy. The understanding of the social factors helps in identifying and aligning the attitudes, the beliefs and the different perceptions people or the community has or hold towards the implementation of the policy.

The willingness of the parents to have their children immunized enables a smooth facilitation of the process of policy implementation. Lack of effective communication or interaction between the agents of social change or policymakers and the families or the targeted community will lead to great failure in the achievement of the goals and objectives of the policy (Crocker-Buque&Mounier-Jack, 2016, p. 690). The agents of social change or the government and other health agencies should conduct a research on the current health needs of the community or families. They should also aim to understand their views on the reasons why they think or think not, that the policy will be of help to them and to the health of their children and how it will promote the general welfare of the society. Taking into the consideration of these social needs will help in facilitating a smooth implementation of the policy. This is because some parents fail to allow their children to be immunized because of lack of understanding on the importance of the immunization to the health of their children while another ride on the community misconceptions or perceptions that the immunization might harm their children (Gallagher et al.,  p. 24, 2014). There is, therefore, a great need for the government and the other health to create mass awareness in their targeted community to reach out to the targeted groups.

Economic Factors

The economic factors affecting the implementation of this policy are the ability of the different families to afford the cost factor of the immunization. In most cases, the government as well as other health agencies such as Commonwealth or world health organization (Vassiliki et al., p. 15, 2014) funds these immunization programs. The government of Australia has set a budget that is primarily targeted at the conscientious objectors of immunization program, but also affects the families or individuals who receive childcare subsidies. In support of the policy, the government has provided $ 161.8 million to be used for over five years for the new proposed new and amended listings in the National Immunization Program Schedule for free vaccines as well as an extra $ 26.4 million for improving the immunization coverage rates and particularly to children and adolescents (MARLOW, p. 15, 2017). This shows that the Australian government is committed to the provision of free immunization vaccines to help in the prevention of diseases.

Since the policy in its strategic approach is aimed at closing of some exemptions from immunization requirements, which have great impact on other health care benefits, enjoyed by parents. Some benefits include the child care benefit and the childcare rebate in a move to make the families or individuals to allow their children have immunization this measure can negatively impact on the parents willingness to have their children immunized (Oku et al., p. 107, 2014). Most of other families could not also have their children immunized because they were not in a position to subscribe to children care benefits, as well as children, care rebate programs. Effective policy implementation will be determined by the ability of the government in ensuring that the cost of administering the policy is less than the benefits accrue from the program as well as ensure that the policy does not add an extra financial obligation to the community and the families. Lack of enough funds to finance the implementation of the program through campaigns and even in the acquisition of vaccines can be a major factor undermining the implementation of the policy.

The political climate of a nation or even the political goodwill towards a certain project may encourage or discourage the expansion of public obligation and henceforth affect policy implementation in either way. Policy implementation has been subject to failure in the past and even in the current state governance and leadership due to lack of political support (Robertson et al., p. 07, 2014). In most cases, politics of a nation and in this case in Australia involves a conflict over the distribution of scarce resources. It is therefore important to note that the levels of political commitment towards the implementation of a policy as well as an enabling legislative environment have been associated with higher levels of immunization coverage and its effectiveness.

Political Factors

The policy has attracted different concerns and views from the political arena of the Australian legislative and leadership positions. In most cases, many leaders have been found to support the implementation of policies in which the leaders have a certain interest attaché to the policy many policies have failed due to lack of political support and goodwill (Duckett, 2015, p. 14). A section of the leadership in Australia has not been supporting the implementation of the policy and especially during the budgetary allocations by the side of the government. Such political divisions in decision making delayed the implementation of the policy since its proposal in 2015. Some sections of leaders were of the opinion that the existing child care health benefits would be enough to facilitate children immunization for the willing population other than using more money on the project which could be used for other development agenda in the country (Warner et al., p. 45, 2015). Others were of the view that only a section or a group of people would benefit from the policy while disadvantaging the other groups which cannot afford the health care benefits for their children. It is therefore important to ensure that a majority of the political class supports the policy by setting its objectives to meet the national health goals (Laskowski, 2016). Such a move will ensure that the policy receives support from a majority as it will equitably improve the health of Australians across all regions.

Policymaking process involves a number of intertwined processes which build each other. In most cases when one process fails it affects the success of the other aspects of the process. Policymaking process involves agenda building, the formulation of the policy, adoption, implementation, evaluation, and termination of the policy once it achieves its set objectives (Hendrix et al., 2016, p. 274). During the agenda-setting stage, it outlines the existing problem that in a wider perspective attracts the attention of government for intervention. If the problem or an issue of concern is identified then the formulation process begins. The formulation process helps to come up with an approach to solve the identified problem. The plan or approach is adopted and implemented in which evaluation is one at different stages of the policy implementation and finally is the termination of the policy if it achieves its objectives or it cans even when it fails to achieve its objectives. Therefore all these processes are connected to each other and therefore the Australian government needs to be observant especially when doing the evaluation of the project in order to understand areas where the failure of the project would have resulted from. For instance on before taking measure on the objectors of the policy.

Conclusion

The success of the implementation of this public health policy willdepend on the efforts of the government in addressing the social factors, the economic factors as well as the political factors affecting the implementation of the policy. It willcall for the collective efforts of the government with all the stakeholders in the public health for the policy to successfully achieve its objectives. Prevention of communicable diseases has therefore been the heart of the Australian government as it is a key element of Australia National Primary health care strategy. This policy is however important as it seeks to improve the immunization coverage among children.

References

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